Making vision care affordable and accessible is core to who we are as a company and for many Americans, accessing eye care is anything but easy. Even if you have insurance, deductibles, copays and coverage gaps can put routine eye exams out of reach. Beyond questions of affordability, there’s the matter of convenience. Between work and family responsibilities, scheduling a trip to the eye doctor can be challenging – making procrastination all too appealing.

But if plenty of people struggle to arrange and afford eye care, those who reside in rural communities may find it particularly challenging. Physicians of all kinds are scarce in many rural areas, but ophthalmologists and optometrists are in especially short supply. As a result, residents of remote places often travel hours to see their eye doctors. To make matters worse, many can’t afford basic vision assessments, let alone the glasses or contacts they need.

Regardless of where you reside, clear vision can massively improve one’s quality of life. Because no American should be denied a chance to see clearly, we created this in-depth guide to rural eye care. We’ll cover the needs, challenges and emerging opportunities related to eye care in rural communities, unpacking problems and proposing real solutions. For those who live far from metropolitan areas, there’s still plenty of hope for vision care of high quality.

First, we’ll break down the obstacles that prevent rural families from obtaining eye care services. Then, we’ll discuss how new technologies are empowering patients to overcome those barriers, and what we’re doing to help.

You don’t have to be a city slicker to take great care of your eyes. With this guide, we’ll help you see eye care in a different light.

Eye Care for Rural Families: Why It Matters So Much

We’re not suggesting that eye care is an exclusively rural challenge: City dwellers and suburbanites also have plenty of reasons to take care of their vision. But when we consider the full range of benefits associated with eye exams, we see why these services can be especially helpful for residents of rural areas.

Accessing Eye Care: Common Barriers in Rural Areas

Clearly, America’s rural communities can benefit substantially from high-quality eye care. Yet many who live far from cities struggle to obtain basic vision services. Which obstacles stand between them and the care they obviously need?

The scarcity of rural eye care reflects a complicated mix of challenges, including financial and logistical barriers. Many of them relate to broad economic patterns that seem unlikely to change soon. But despite these significant difficulties, there’s still plenty of reason for hope. Once we understand the obstacles rural Americans face in accessing eye care, we can turn towards effective solutions.

Economic Insecurity

Historically, rural corners of the country have had higher poverty rates than urban areas. And while that gap has narrowed in recent decades, rural Americans remain more likely to be poor. Sadly, children are particularly prone to this disparity: According to federal estimates, 23 percent of rural kids live below the poverty line.

These troubling trends reflect several kinds of financial hardship, but the most important factor may be the loss of solid jobs across rural America. As blue-collar jobs decline due to economic and technological change, older workers find themselves unemployed, while young people seek work elsewhere.

For rural residents on tight budgets, basic medical care can be intimidatingly expensive. And when forced to make health care sacrifices, many deprioritize eye exams, imagining they are inessential. In fact, recent research suggests that eye care is one of the services Americans are most likely to delay for financial reasons.

Even if rural Americans do make it to the eye doctor, they may find themselves unable to fill their new prescriptions. Eyeglasses are nearly always expensive, with the average pair of prescription frames costing $231 – and some styles costing several times more.

Additionally, compared to folks living in suburbs or cities, rural Americans are more likely to lack any kind of health insurance. It seems unlikely that individuals without general health insurance would choose vision coverage alone. Therefore, it’s safe to assume that many rural families face steep out-of-pocket costs for eye care, glasses and contacts.

Federal Programs Fall Short


Of course, many rural Americans with low incomes do have access to federal health care benefits, including Medicaid, Medicare and the Children’s Health Insurance Program (CHIP). In fact, with the expansion of Medicaid in recent years, 1.7 million individuals in rural areas have newly gained coverage. But while these programs may help individuals access other kinds of health services, they’re often insufficient when it comes to eye care.

In states such as California, Medicaid does not offer any benefits for eyeglasses or other visual aids. In other places, patients face strict limitations, such as a single pair of eyeglasses every five years.

Medicare, which primarily serves older Americans, does cover eye care for those with ocular illnesses or diabetes. But seniors who simply want a routine eye exam are out of luck. Additionally, glasses and contacts aren’t covered.

CHIP coverage offers slightly better vision benefits, but as its name suggests, children are the only ones eligible. Plus, rural families may have to search far and wide for a provider who will take their CHIP benefits. While the number of federally qualified health centers offering eye care services has increased in recent years, many still lack this capability.

Distance to a Doctor

America’s rural communities face a severe shortage of qualified medical professionals, and optometrists and ophthalmologists are no exception. Unfortunately, this crisis seems likely to deepen in the coming decades, with a predicted shortage of 120,000 physicians by 2030.


While data concerning the distribution of eye specialists is scarce, many remote communities are deeply underserved. A 2015 study found that nearly a quarter of American counties had no ophthalmologists or optometrists in them at all.

Economic factors are partly to blame: Physicians can make more money in big cities. When you graduate from medical school with student debt in the low six figures, a higher salary is hard to resist. Another element is professional isolation: Doctors can get lonely without colleagues around for miles. This dynamic can create a vicious cycle, with doctors moving away and no one willing to replace them.

For patients in rural communities, the results are predictable and problematic: They must drive long distances to receive routine eye care services, or do without them entirely. Even obtaining an appointment can be frustratingly difficult. In areas where demand overwhelms the few available doctors, wait times can stretch for weeks.

Eye Care Anywhere: The Transformative Power of Tech

If rural Americans navigate serious challenges to obtain eye care, what can be done to make routine exams and visual aids more accessible? In our mission to bring clear vision to rural families across the country, its seems we have our work cut out for us.

At first, many of the barriers we’ve discussed appear extraordinarily difficult to address. When broader changes in our society imperil rural economies, how can we make basic eye care affordable? What can be done about geographical realities, which keep rural patients hours away from care? Is there any solution to the deepening doctor shortage outside of America’s cities?

It’s true that these challenges are formidable, involving many factors beyond the control of medical professionals. But for residents of rural areas and the nation as a whole, there’s excellent news regarding access to eye care. Thanks to emerging technologies, exams, glasses and contacts are easier to get and more affordable than ever. Here’s how virtual tools are transforming the way Americans take care of their eyesight.\

The Telemedicine Transition

Telemedicine, the use of communication tools and information technology to provide health care at a distance, is rapidly reshaping how Americans interact with their doctors. Initially conceived to aid rural communities, telemedicine permits physicians to diagnose and treat patients living miles away. In place of direct examination, doctors rely on video conferencing and digital examination equipment to assess and engage with patients.


Increasingly, however, residents of urban and suburban communities have also embraced the benefits of virtual care. According to some projections, Americans will take part in over a billion virtual appointments per year by 2025.


What explains the rising popularity of telemedicine technologies, both for rural communities and America at large? In terms of convenience, cost and quality, virtual care offers considerable advantages.


  • See your doctor, skip the trip: Whether you’re feeling ill or simply need a routine exam, telemedicine offers you access to care from the comfort of your couch. That’s a benefit for any patient, but rural families stand to benefit particularly from that perk. If the nearest physician is over an hour away, an in-person visit could require missing work – an unwelcome prospect for families on a budget. With virtual care, your appointment probably won’t take longer than a lunch break. Some healthcare apps even let you record your data at your convenience; a doctor examines your results later.
  • Care of equal quality: A number of recent studies suggest that virtual doctor’s appointments deliver patient satisfaction on par with in-person visits. Some patients even prefer the care they receive via telemedicine. Of course, connections between individuals and their doctors are deeply important: If your trusted physician doesn’t do virtual visits, you may still prefer office visits. But most folks rate telemedicine as equal to in-person care, suggesting that rural communities won’t be shortchanged by relying on virtual appointments.


  • Appointments are affordable: Virtual consultations aren’t just more convenient: Researchers suggest that could result in serious savings. One 2017 study assessed the average cost of a virtual visit at approximately $79, compared to $146 for in-person appointments. For rural families working hard to make ends meet, slashing the price of a visit in half is no small savings.

With the latest generation tech at our disposal, we’re taking vision exams into the realm of telemedicine, helping rural families overcome barriers to care.

Vision Care Goes Virtual

Driven by the lack of eye care professionals in rural areas, online vision exams have emerged to serve individuals left behind by traditional healthcare systems. Unlike some forms of telemedicine, ophthalmology can be conducted asynchronously, making it more convenient for doctors and patients.

This simply means that assessment happens in two stages. First, patients interact with digital tools to capture data about their eyes. Second, trained ophthalmologists study those data and reach a decision about necessary next steps. This process could result in treatment recommendations (like a prescription for glasses or contacts) or a referral for further testing if more serious issues seem possible.

At 1-800-Contacts, we’re leading the way in taking online vision exams virtual. Our own ExpressExam process makes online visual exams accessible for all patients, whether they live in rural areas or urban centers.

And while it doesn’t replace a comprehensive eye exam, this more affordable option allows you to renew your current prescription in a more convenient way.

As far as total eye health exams go, we recommend following the American Academy of Ophthalmologists‘ guidelines. (generally, every 2-4 years for individuals 40-54 years and every 1-3 years for individuals 55-64 years old).

Here’s how ExpressExam works:

  • Step 1: Using your phone, tablet or computer, you answer a few simple questions. Then, just as you would in your doctor’s office, you look at some images and report what you see. Remember those charts with letters in various sizes? Express Exam has them, too.
  • Step 2: Once your results are in, a board-certified ophthalmologist reviews your results and determines whether a prescription can be renewed. The physicians include professors from leading universities and luminaries in the field, so you always know you’re in excellent hands.
  • Step 3: Within 24 hours of taking your exam, you’ll get your guaranteed-accurate results. Because the process never takes longer than a day, you can quickly move forward with ordering your contacts.

Whether you live far from an ophthalmologist or simply value convenience, ExpressExam can revolutionize your eye care experience. Sound too good to be true? Check out our testimonials or try it for yourself.

Making Contacts in Your Community

We hope this guide to rural eye care provides a clear view of the challenges faced by remote communities – and the new solutions made possible by emerging technologies. We’re proud to be part of the effort to bring eye care to more Americans, eliminating financial and geographical barriers in the process.

Wherever you live, you can join us in that effort. Many people are unaware that online vision exams exist – and even fewer understand that they’re so affordable. If you know someone who may be delaying a vision exam on account of cost or accessibility, we hope you’ll let them know that they have options. Thanks to our digital tools, no one needs to endure impaired vision unnecessarily.

That’s a message that resonates in all corners of the country, from rural towns to massive metropolises. Wherever you call home, we’re here to help.